Active NPI
Kevin Anthony Pidgeon, PHARMD
- Pharmacist
- Corona, CA
National Provider Identifier
1902900277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36706
- Practice address
- 800 Magnolia Ave
Suite 116
Corona, CA 92879-3123 - Phone
- (951) 737-3511
- Fax
- (951) 737-2148
- NPI assigned
- Sep 8, 2006
- Last updated
- Mar 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36706 | CA | Primary |
Addresses
Primary practice location
800 Magnolia Ave
Suite 116
Corona, CA 92879-3123
Mailing address
800 Magnolia Ave
Suite 116
Corona, CA 92879
Phone (951) 737-3511
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0553506 | Other | NABP | |
| PHA445220 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36706 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmieri Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1902900277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 MAGNOLIA AVE",
"address_2": "SUITE 116",
"city": "CORONA",
"state": "CA",
"postal_code": "92879",
"telephone_number": "951-737-3511",
"fax_number": "951-737-2148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MAGNOLIA AVE",
"address_2": "SUITE 116",
"city": "CORONA",
"state": "CA",
"postal_code": "928793123",
"telephone_number": "951-737-3511",
"fax_number": "951-737-2148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIDGEON",
"first_name": "KEVIN",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-08",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "36706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "0553506",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PHA445220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.